Legal Briefs (June 2012)

Through the work of the Legal Defense Fund, NASW joined an amicus brief filed in the Superior Court of Arizona for the case, State v. King. NASW is among a coalition of amici groups and professionals that are supporting a petition for post-conviction relief for a woman who exhibited symptoms of postpartum psychosis, but who was not properly diagnosed or treated.

In 2002, Hope Lynette King was convicted of felony child abuse and sentenced to 40 years in prison. The brief states that it is now understood that King likely suffered from postpartum psychosis, an illness that many in the medical and mental health communities were not fully aware of or educated about during King’s trial.

Advancements in the understanding of reproductive mental health, including postpartum psychosis, have come to light since 2002, the brief argues. These newly discovered facts probably would have changed King’s verdict had the information been available at the time of her trial, it says. According to Arizona criminal procedure rules, anyone convicted of or sentenced for a criminal offense may seek relief from the court if newly “discovered material facts probably exist and such facts probably would have changed the verdict or sentence.”

The period of reproductive transition is recognized as a time of biological and chemical destabilization that increases a woman’s vulnerability to psychiatric illness, the brief says, and it is now understood that hormonal transition in childbirth triggers a neuroendocrine response producing changes in brain chemicals associated with mood.

During pregnancy, hormone levels can increase up to 200 fold during the course of gestation, and within 24 hours the precipitous drop in estrogen and progesterone produces a biological shock to the system, according to reports cited in the brief. “This abrupt change in hormone levels alters neurotransmitters in the brain, creating mental health symptoms,” it states.

The hormone withdrawal, with its profound impact on brain chemistry, has the potential to trigger postpartum mental illness in women with a history of mental illness prior to pregnancy and/or with significant life stressors, such as the demands of caring for the baby, sleep disruption, poor quality of interpersonal relations and support, unsolved psychological conflicts, or exposure to violence, it adds.

Stigma and shame for the new mother have traditionally kept many from treatment, the brief says. “But treatment has also been confounded by a historical lack of curriculum and training in this area of women’s health,” it states. “Thus, the time King gave birth to her child in 2000, perinatal mood and anxiety disorders were not systemically addressed through screening, identification and treatment. Since then, identification of these disorders has improved greatly through research and education.”

The brief notes that evidence shows King likely suffered from postpartum psychosis and therefore could not have understood the consequences of her actions. It adds that if the jury had had the opportunity to hear evidence of the science of postpartum psychosis, it would have reached a different verdict.